C-Reactive Protein Level as Diagnostic Marker in Young Febrile Children Presenting in a General Practice Out-of-Hours Service.

J Am Board Fam Med

From the Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands (MK, GE, BWK, AMB, MYB); and the Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (MYB).

Published: November 2017

Background: It is unclear how well a C-reactive protein (CRP) value predicts a serious infection (SI) in young febrile children in general practice.

Methods: This prospective cohort study with 1-week follow-up included children, aged 3 months to 6 years, presenting with fever to a general practitioner out-of-hours service. We evaluate whether CRP level has predictive value for diagnosing a child at risk for an SI either at presentation or during follow-up. The index test was CRP ≤20 mg/L (rule out an SI) and >80 mg/L (rule in an SI). The reference standard was referral to a pediatric emergency department or diagnosis of an SI. The main outcome measure was CRP value.

Results: CRP level was available for 440 children. To rule out an SI, CRP ≤20 mg/L did not change the probability of having no SI (87.5%). CRP >80 mg/L increased the probability of having an SI from 11.4% (pretest probability) to 21.2% (posttest probability). In children without a diagnosis of SI at presentation, CRP could not predict an SI during follow-up (CRP >80 mg/L: positive likelihood ratio, 2.1, 95% confidence interval, 1.3-3.5; CRP ≤20 mg/L: negative likelihood ratio, 0.9, 95% confidence interval, 0.7-1.2).

Conclusions: In general practice CRP has little clinically relevant value in discriminating febrile children in need of medical care from those who are not.

Download full-text PDF

Source
http://dx.doi.org/10.3122/jabfm.2016.04.150315DOI Listing

Publication Analysis

Top Keywords

febrile children
12
crp ≤20
12
≤20 mg/l
12
>80 mg/l
12
crp
11
c-reactive protein
8
young febrile
8
general practice
8
out-of-hours service
8
crp level
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!